Medical Billing Forum

Coding => Coding => Topic started by: MFunk on March 01, 2012, 11:26:38 AM

Title: coding question family practice
Post by: MFunk on March 01, 2012, 11:26:38 AM
I have a new provider and he has been billing 99213 routine office visit with 11056 (paring and cuttin)
Second code is deniey as incorrect modifier or modifier missing. I see where the cliam was submitted w/ a modifier placement 99213 (25) 11056 (59)
It has also been sent w/o the modifier 59.
What is correct? How should I been sending this claim out for payment? Thanks!
Title: Re: coding question family practice
Post by: koatsj on March 01, 2012, 11:33:36 AM
If the documentation supports the need to bill an office visit with the procedure code, you need to add -25 modifier onto the e/m. You don't need modifier -59.